Multi-Trial Gait Adaptation of Healthy Individuals during Visual Kinematic Perturbations

Optimizing rehabilitation strategies requires understanding the effects of contextual cues on adaptation learning. Prior studies have examined these effects on the specificity of split-belt walking adaptation, showing that contextual visual cues can be manipulated to modulate the magnitude, transfer, and washout of split-belt-induced learning in humans. Specifically, manipulating the availability of vision during training or testing phases of learning resulted in differences in adaptive mechanisms for temporal and spatial features of walking. However, multi-trial locomotor training has been rarely explored when using visual kinematic gait perturbations. In this study, we investigated multi-trial locomotor adaptation in ten healthy individuals while applying visual kinematic perturbations. Subjects were instructed to control a moving cursor, which represented the position of their heel, to follow a prescribed heel path profile displayed on a monitor. The perturbations were introduced by scaling all of the lower limb joint angles by a factor of 0.7 (i.e., a gain change), resulting in visual feedback errors between subjects' heel trajectories and the prescribed path profiles. Our findings suggest that, with practice, the subjects learned, albeit with different strategies, to reduce the tracking errors and showed faster response time in later trials. Moreover, the gait symmetry indices, in both the spatial and temporal domains, changed significantly during gait adaptation (P < 0.001). After-effects were present in the temporal gait symmetry index whens the visual perturbations were removed in the post-exposure period (P < 0.001), suggesting adaptation learning. These findings may have implications for developing novel gait rehabilitation interventions.